Prevalence Of T2D Research Articles

Exposure to p,p′-dichlorodiphenyldichloroethylene (DDE) induces fasting hyperglycemia without insulin resistance in male C57BL/6H mice

Approximately 8.3% of the United States (U.S.) population have either diagnosed or undiagnosed diabetes mellitus. Out of all the cases of diabetes mellitus, approximately 90–95% of these cases are type 2 diabetes mellitus (T2D). Although the exact cause of T2D remains elusive, predisposing factors include age, weight, poor diet, and a sedentary lifestyle. Until recently the association between exposure to environmental contaminants and the occurrence of diabetes had been unexplored. However, recent epidemiological studies have revealed that elevated serum concentrations of certain persistent organic pollutants (POPs), especially organochlorine pesticides, are positively associated with increased prevalence of T2D and insulin resistance. The current study seeks to investigate if this association is causative or coincidental. Male C57BL/6H mice were exposed to DDE (2.0mg/kg or 0.4mg/kg) or vehicle (corn oil; 1mL/kg) for 5 days via oral gavage; fasting blood glucose, glucose tolerance, and insulin challenge tests were performed following a 7 day resting period. Exposure to DDE caused significant hyperglycemia compared to vehicle and this hyperglycemic effect persisted for up to 21 days following cessation of DDE administration. Intraperitoneal glucose tolerance tests and phosphorylation of Akt in the liver, skeletal muscle, and adipose tissue following insulin challenge were comparable between vehicle and DDE treated animals. To determine the direct effect of exposure to DDE on glucose uptake, in vitro glucose uptake assays following DDE exposure were performed in L6 myotubules and 3T3-L1 adipocytes. In summary, subacute exposure to DDE does produce fasting hyperglycemia, but this fasting hyperglycemia does not appear to be mediated by insulin resistance. Thus, the current study reveals that subacute exposure to DDE does alter systemic glucose homeostasis and may be a contributing factor to the development of hyperglycemia associated with diabetes.

Screening for people with glucose metabolism disorders within the framework of the DEMOJUAN project (DEMOnstration area for primary prevention of type 2 diabetes, JUAN Mina and Barranquilla, Colombia).

Until now, no systematic screening for T2D or prevention activities targeting T2D has been implemented in Colombia. The aims of this study were i) describe the feasibility of implementing the Finnish Diabetes Risk Score (FINDRISC) as a screening tool for glucose metabolism disorders (GMD) in the primary health care system in Barranquilla in Colombia during 2011 and 2012, and ii) to describe the risk factors for T2D in the population screened. This screening was opportunistic among people aged 34-60 years living in five primary health care catchment areas in Barranquilla, Colombia. People with 13 or more FINDRISC points were invited to an oral glucose tolerance test (OGTT). Out of 14193 participants with the FINDRISC completed, 35% (n=4915) had a score of 13 points or higher (men 23%, women 40%). Among those with FINDRISC completed, the percentage of people with BMI<25 kg/m2 was 46% in men and 35% in women. The prevalence of screen-detected T2D was 18% in men and 12% in women, respectively, among those with FINDRISC >12 attending an OGTT. In both sexes the prevalence of isolated IGT, isolated IFG, and IFG and IGT combined were 8%, 11%, and 8%, respectively. In total, 2% of all 14 193 screened participants had undetected T2D and 7% GMD. This figure would potentially be 4.6% (T2D), respectively 15% (GMD) if all with a FINDRISC>12 attend the OGTT. Thus, we found the FINDRISC to be a useful tool to identify people with GMD. This article is protected by copyright. All rights reserved.

Prevalence of type 2 diabetes, obesity and the metabolic syndrome among Canadian First Nations children in a remote Pacific coast community

Type 2 diabetes mellitus (T2D) in children and adolescents is a growing public health concern. Although the prevalence of T2D in First Nations children has been documented to be as high as 1% in central Canada, no paediatric data are available for any Aboriginal community in British Columbia (BC). To determine the prevalence of obesity, glucose intolerance and the metabolic syndrome in children living in a remote BC First Nations community. Children who were six to 18 years of age and living in the community of Hartley Bay, BC, participated in the study. A medical history, a physical examination and a 2 h oral glucose tolerance test were completed. Overweight was defined as a body mass index between the 85th and 95th percentiles, and obese was defined as a body mass index greater than or equal to the 95th percentile, which were standardized for age and sex. Thirty of 34 children (88%) participated (mean +/- SD age 11.8+/-3.4 years). Ten children (33%) were obese, and five (17%) were overweight. There were seven children (23%) with abnormal glucose tolerance as per the 2007 American Diabetes Association criteria: five with only impaired fasting glucose ([IFG] 5.6 mmol/L to 6.9 mmol/L), one with both IFG and impaired glucose tolerance and one with T2D. However, using the 2008 Canadian Diabetes Association criteria, two children (6.7%) had abnormal glucose tolerance (one with IFG plus impaired glucose tolerance and one with T2D) because no child met the definition for IFG alone (6.1 mmol/L to 6.9 mmol/L). Four children (13%) met the criteria for the metabolic syndrome. There is a high prevalence of the components of the metabolic syndrome, including overweight, obesity and abnormal glucose tolerance, in the children of this community.

Family history of type 2 diabetes is increased in patients with type 1 diabetes

It has been suggested that type 1 (T1D) and type 2 diabetes (T2D) might share some susceptibility risk factors. A higher prevalence of T2D has been reported in families of Caucasian T1D children than in the general population, although data in adults and multiethnic groups is still lacking. Our goal was to compare the prevalence of T2D family history between adults with T1D from a multiethnic population and a non-diabetic control group. We performed a cross-sectional analysis of 145 adults with T1D and 141 healthy adults (control group) that included an interview and a review of the medical charts. Groups were matched for age, sex, ethnicity and body mass index (BMI). We found a higher prevalence of not only T1D but also T2D in first-degree relatives of patients than in controls ( p < 0.001 and p = 0.042, respectively). These differences were not observed for second/third-degree relatives. When subjects were stratified according to their ethnicity, the higher frequency of T2D in FDR of patients than controls became more striking in non-white ( p = 0.002) and disappeared in white individuals ( p = 0.85). To conclude, the prevalence of T1D and T2D was higher in first-degree relatives of patients with T1D than of controls. The difference in T2D family history between patients and controls was specially striking among non-whites, which may represent a peculiarity of T1D in this group.

Incidence of diabetes mellitus among children of Italian migrants substantiates the role of genetic factors in the pathogenesis of type 1 diabetes

To investigate the role of genetic and environmental factors in the pathogenesis of type 1 diabetes mellitus (T1D), we carried out a study in Germany aimed at comparing the prevalence and incidence of T1D among children of migrant Italians from high-risk (Sardinia) and low-risk (continental Italy) regions versus German children. Children from Italy were identified by the "Baden-Wuerttemberg (BW) Diabetes Incidence Registry", which registered 4017 newly diagnosed T1D patients, aged 0-14 years, between 1987 and 2003. Data relating to T1D children from Sardinia were elicited from more than 2000 questionnaires. Our findings were: (1) T1D is more frequent among German children than among children of Italian migrants [incidence rate (IR) 14.8/100,000/year, 95% confidence interval (CI) 14.4-15.4 vs. IR 10.8/100,000/year, 95% CI 8.2-13.6); (2) the incidence of T1D among Italian children residing in Germany is similar to that of Italian children in the home country (IR 10.8/100,000/year, 95% CI 8.2-13.6 vs. 8.4/100,000/year, 95% CI 7.9-8.9); (3) the prevalence of T1D among Sardinian children is higher than that among German children (0.11%, 95% CI 0.11-0.12) independent of the place where the Sardinian children are living (Sardinian children in Germany 2.3%, 95% CI 0.5-6.5 vs. Sardinian children in Sardinia 0.30%, 95% CI 0.27-0.32). Children from high- and low-risk areas of Italy have incidence rates of T1D that are closer to those of their native regions than to those of German children, indicating that genetic factors play a predominant role in the pathogenesis of T1D.

Nonfatal Stroke, Cardiac Disease, and Diabetes Mellitus in Hypopituitary Patients on Hormone Replacement Including Growth Hormone

The impact of long-term GH replacement on cerebrovascular and cardiovascular diseases and diabetes mellitus in hypopituitary patients is unknown. The incidence of nonfatal stroke and cardiac events, and prevalence of type 2 diabetes mellitus (T2D) and cardioprotective medication were compared between cohorts of GH-deficient (GHD) patients and population controls. The incidence of nonfatal stroke and cardiac events was estimated retrospectively from questionnaires in 750 GHD patients and 2314 matched population controls. A prevalence of T2D and cardioprotective medication was recorded at the distribution of questionnaires. Time since first pituitary deficiency to start of GH therapy was 4 and 2 yr, and time on GH therapy was 6 yr for GHD women and men, respectively. Lifelong incidence of nonfatal stroke was tripled in GHD women and doubled in GHD men, but a decline was seen in both genders during periods after first pituitary hormone deficiency and GHD, during which most patients had GH therapy. The lifelong incidence of nonfatal cardiac events declined in GHD men during first pituitary hormone deficiency and GHD periods. GHD women had a higher prevalence of T2D and lipid-lowering medication, whereas GHD men had a higher prevalence of antihypertensive medication. The declined risks of nonfatal stroke in both genders and of nonfatal cardiac events in GHD men during periods on GH replacement may be caused by prescription of cardioprotective drugs and 6-yr GH replacement. GHD women had an increased prevalence of T2D, partly attributed to higher body mass index and lower physical activity.

PREVALENCE OF OBESITY AND TYPE 2 DIABETES AMONG CHILDREN IN A REMOTE FIRST NATIONS COMMUNITY.

Background Type 2 diabetes mellitus (T2D) in children and adolescents is becoming a growing public health concern and reflects the increasing rates of obesity in our society. The prevalence of T2D in Canadian Aboriginal children and youth has been documented to be as high as 1%, with the highest prevalence in the Plains Cree people of Central Canada. However, no such pediatric data are available for any First Nations community in British Columbia. Hartley Bay is an isolated First Nations community in BC, accessible only by air or water, with a population of 184 members living on reserve. Members of this community have multiple known risk factors for developing T2D, including First Nations ethnicity, obesity, and a family history of T2D. Purpose The purpose of this study was to determine the prevalence of obesity, glucose intolerance, and metabolic syndrome in the community of Hartley Bay. Methods All children in the community of Hartley Bay, ages 6 to 18, were invited to participate in the study. A medical history was obtained to document risk factors and symptoms associated with T2D. Measurements including height, weight, blood pressure, and waist and hip circumferences were documented. Body mass index (BMI) was standardized for age and sex. Overweight was defined as a BMI ≥ 85th percentile and obese was defined as a BMI ≥ 95th percentile for age and sex. Presence of acanthosis nigricans, hirsutism, and acne were recorded. Children fasted overnight, and a standard oral glucose tolerance test was administered the following morning. Baseline and 2-hour levels of glucose and insulin were measured. Glycosylated hemoglobin, fasting C-peptide, and fasting lipid profile were also obtained. Results There were 33 eligible children, and 29 children (88%) (age 11.8 years ± 3.4; 16 females and 13 males) participated in the study. Nine (31%) of the children were obese and 5 (17%) were overweight, with a total of 48% obese or overweight. One child had fasting and 2-hour glucose levels consistent with impaired glucose tolerance. One other child, absent from the community at the time of the screening, was previously recently diagnosed by this team to have T2D. The incidence of glucose intolerance (T2D/IGT) in this community is 2/34 (5.9%), which is greater than previously reported in other pediatric Aboriginal populations in Canada. Conclusions Our findings suggest that the prevalence of obesity and overweight as well as glucose intolerance in this population is higher than previously reported in other pediatric Aboriginal populations in Canada. This study will generate interest, knowledge, and the willingness within the community to support modifications in lifestyle and nutrition practices required for the primary and secondary prevention of T2D.

Cold climate genes and the prevalence of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2D) is approaching epidemic proportions globally. However, some human populations, such as Western-Europeans, have a lower prevalence compared with urban or westernized groups with origins in warmer climates. To explain this conspicuous trend we have developed a hypothesis suggesting that pressure for survival on ancestral Western-Europeans (or on other human populations) in extremely cold climates could lead to selection for a combination of specific genes or alleles, which we have named cold climate genes, promoting adaptation to these condition. The possible molecular basis for the effects of these genes could lead to decreasing susceptibility to T2D. The possible candidates for cold climate genes have been evaluated from three areas: the uncoupling proteins, maternally-transmitted mitochondrial genes, and mitochondrial biogenesis. The possible existence of cold climate genes can lead to both increased thermogenesis and decreased prevalence of T2D. This may help explain the variations in prevalence of T2D in different ethnic groups. This consideration suggests testable experimental approaches towards prevention and therapies for T2D.

An association between type 1 diabetes and idiopathic generalized epilepsy

Idiopathic generalized epilepsies (IGEs) account for approximately 30% of all patients with epilepsy. Both the IGEs and type 1 diabetes mellitus (T1D) represent serious worldwide problems, because of related medical and social management costs. Clinical experience suggested the two conditions were seen in individuals more frequently than might be expected by chance. We compared the population prevalence of T1D in 15- to 30-year-olds to a cohort of 518 15- to 30-year-olds with IGE. We found a highly significant excess of T1D in our IGE cohort, with an odds ratio of 4.4 (95% confidence interval, 2.1-9.2). Our results suggest that the prevalence of T1D is increased by a factor of four in young adults with IGE. To our knowledge, this is the first published association between the two conditions and expands the diseases known to be associated with T1D.